Small update. Physio again today. My vertical lift is 120 degrees on the right and 110 degrees on the left, +20 degrees improvement in a month, but still a long way to go, doctor was hoping for 160 in two weeks time but I think thats probably ambitious. Strength is really poor on the outer arm muscle which probably has a technical name (didn't have much to lose on the upper body strength).

Went for a drive yesterday and visited the velodrome for training and had a chat. That plus hydrothrapy yesterday made for a sore morning at the physio so that may have skewed the results a bit.

Not much else to report, just sticking at it.

Hooked the bike up to the mag trainer but haven't done a session yet. Sat on it briefly and it was too uncomfortable. Might try again on the weekend.

Been a while since I updated. Jules21 thread reminded me to post this, originally posted on my club forum last week:

I had my first x-ray checkup at the end of May, and it was found that my left shoulder is most likely suffering from necrosis. Somewhat speculative as the x-rays can't completely confirm it until the structure of the bone starts to deteriorate and by that point its too late for further treatment. I was given a referral to an Endocrinologist to see about a therapy that they use for osteoporosis patients that may prevent the necrosis from progressing.

I booked him in for mid this month as he was on leave, but was willing to see me his first day back. In the mean time I had blood tests for a bunch of things and a Bone Density scan in preparation for the appointment to speed everything along.

Had the appointment and discussed the medication, its side effects and treatment and was booked in last Wednesday to receive it. Was required to take some large doses of Vitamin D on a weekly basis to help with the treatment. The drug used is a bisphosphonate called Zoledronic acid. It requires 1 infusion now and another in 6 weeks time, followed by xrays after that to see if anything has changed.

On Wednesday last week I had my first treatment. Apparently they're all done on this day so it was me and a group of ladies, all of which old enough to be my grandmother, waiting for our turn. The drug is given over a 15 minute infusion through a drip. It was all pretty straight forward and no immediate effects.

I went to work afterwards and was fine for the rest of the day. The side effects kicked in that evening and it wasn't particularly pleasant. It felt like a flu but no coughing/runny nose. Just ached all over and had a headache. Felt really tired, lethargic, and weak. Stayed like that for two days, which I barely left the bed. My shoulders got very sore, but this could be from lying in bed for prolonged lengths. I brightened up a bit on the weekend and I think I'm now better, but suffering a little from fatigue. Shoulders aren't sore anymore (seem to return to normal levels) and I'm moving around more.

Hopefully the drug is doing some good. Its somewhat experimental but weighing up the risks and the possibly positive outcome I think its worthwhile trying. It was pretty expensive too considering its a off script usage from medicare, and therefore all out of pocket.

I had several treatments with the (experiemental..) zoledronic acid for the necrosis, and it seems this has worked. My humeral heads have not collapsed, and it looks like I'm past the danger time frame for this occurring. Had a bone scan with spect to determine if the heads had re-vascularised, and they have (except for a small section, but apparently this should come good). Will have another bone scan in 6 months time to confirm everything is still good.

Saw the orthopaedic surgeon too, he has no concerns now and says any further treatment will be up to me. I should be doing as much physio as possible, and in 4-5 months time I can evaluate where my movement is at. I still haven't plateaued yet in strength and range. It may then be possible to get more movement by doing some key-hole surgery to remove scarring in the joint. This involves an overnight stay but apart from that is fairly low risk and won't cause me to have to start again as far as learning to use my arms goes.

I probably have 75% percent of my left arm range back, and 65% of my right. I plan to get to the Velodrome tomorrow night for my first ride back since the accident in January. I've gone from being a super fit 70kg, to a fat 83kg in that time.

I've been doing a few commutes, including today - and everyone overtakes me. Also been to Centennial Park on Saturday mornings. Longest ride has been about 40km, and was slow (~25km/h). Getting my fitness back up slowly, haven't lost any weight yet but not too concerned. Shoulders are doing well - I think the riding is helping. Still doing lots of physio.

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